Healthcare Provider Details
I. General information
NPI: 1851218390
Provider Name (Legal Business Name): LUMINACOUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 S ROCK RD
WICHITA KS
67210-1801
US
IV. Provider business mailing address
2800 S ROCK RD
WICHITA KS
67210-1801
US
V. Phone/Fax
- Phone: 316-648-5232
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
MIAH
BALL
Title or Position: OWNER
Credential: LPC
Phone: 316-648-5232